Bub, Carol Lisa

Bub, Carol Lisa is an individual health care provider with primary practice located at 619 Dalton St , Emmaus PA 18049-3031. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bub, Carol Lisa can be contacted via phone (610) 628-8200.

Contact Information

Primary practice address
619 Dalton St Emmaus PA 18049-3031
Phone: (610) 628-8200
Fax: (610) 965-6595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD059650L Pennsylvania

Profile Details

NPI number 1215937271
LBN Legal business name Bub, Carol Lisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Sep 10th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215937271 NPPES
Pennsylvania MEDICAID 0016133000002

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